Pulmonary embolism from a venous thrombosis distal to the popliteal vein

A case of pulmonary embolism from a venous thrombosis distal to the popliteal vein is reported. This occurred despite venographic and ultrasound verification that the thrombus had not extended to the popliteal vein. The medical literature supports expectant treatment of "calf-only" venous thrombi. Our case clearly demonstrates that clinically significant pulmonary emboli can arise from calf vein thrombi without popliteal involvement.